Training and Validating a Portable Electronic Nose for Lung Cancer Screening

Goor, Rens van de; Hooren, Michel van; Dingemans, Anne‐Marie C.; Kremer, Bernd; Kross, Kenneth W.

doi:10.1016/j.jtho.2018.01.024

Cited by 107 publications

(82 citation statements)

References 27 publications

(34 reference statements)

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“…Previous studies have shown that electronic nose technology based on pattern recognition of VOCs or identifying VOCs with gas chromatography/mass spectrometry can differentiate between subjects with and without lung cancer [13,14,17,20,[27][28][29]. Several studies using techniques for VOC identification have used logistic regression analysis to identify lung cancer-specific VOCs [30,31].…”

Section: Discussionmentioning

confidence: 99%

“…VOCs are of interest since they might be directly related to the presence of diseases, they can be tested noninvasively and pattern recognition techniques can serve as classifiers for diseases. Several studies on exhaled-breath analysis have supported the hypothesis that VOC patterns alter when lung cancer is present [13][14][15][16][17][18][19][20].…”

Section: Introductionmentioning

confidence: 96%

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Improving lung cancer diagnosis by combining exhaled-breath data and clinical parameters

et al. 2020

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IntroductionExhaled-breath analysis of volatile organic compounds could detect lung cancer earlier, possibly leading to improved outcomes. Combining exhaled-breath data with clinical parameters may improve lung cancer diagnosis.MethodsBased on data from a previous multi-centre study, this article reports additional analyses. 138 subjects with non-small cell lung cancer (NSCLC) and 143 controls without NSCLC breathed into the Aeonose. The diagnostic accuracy, presented as area under the receiver operating characteristic curve (AUC-ROC), of the Aeonose itself was compared with 1) performing a multivariate logistic regression analysis of the distinct clinical parameters obtained, and 2) using this clinical information beforehand in the training process of the artificial neural network (ANN) for the breath analysis.ResultsNSCLC patients (mean±sd age 67.1±9.1 years, 58% male) were compared with controls (62.1±7.0 years, 40.6% male). The AUC-ROC of the classification value of the Aeonose itself was 0.75 (95% CI 0.69–0.81). Adding age, number of pack-years and presence of COPD to this value in a multivariate regression analysis resulted in an improved performance with an AUC-ROC of 0.86 (95% CI 0.81–0.90). Adding these clinical variables beforehand to the ANN for classifying the breath print also led to an improved performance with an AUC-ROC of 0.84 (95% CI 0.79–0.89).ConclusionsAdding readily available clinical information to the classification value of exhaled-breath analysis with the Aeonose, either post hoc in a multivariate regression analysis or a priori to the ANN, significantly improves the diagnostic accuracy to detect the presence or absence of lung cancer.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 96%

Improving lung cancer diagnosis by combining exhaled-breath data and clinical parameters

et al. 2020

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“…Patient conditioning also varied between studies. In Wang's study participants did not eat or smoke for 12 hours prior to sampling, whereas Van der Goors' study had no such limitations, 126,130 . These differences make combining data to apply conclusions to a large population very difficult.…”

Section: Clinical Research To Datementioning

confidence: 99%

The potential of breath analysis to improve outcome for patients with lung cancer

et al. 2019

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Lung cancer remains the most common cause of cancer related death in both the UK and USA. Development of diagnostic approaches that have the ability to detect lung cancer early are a research priority with potential to improve survival. Analysis of exhaled breath metabolites, or volatile organic compounds (VOCs) is an area of considerable interest as it could fulfil such requirements. Numerous studies have shown that VOC profiles are different in the breath of patients with lung cancer compared to healthy individuals or those with non-malignant lung diseases. This review provides a scientific and clinical assessment of the potential value of a breath test in lung cancer. It discusses the current understanding of metabolic pathways that contribute to exhaled VOC production in lung cancer and reviews the research conducted to date. Finally, we highlight important areas for future research and discuss how a breath test could be incorporated into various clinical pathways.

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“…Circulating free DNA seems more suitable for determining driver gene mutations rather than for early diagnosis; likewise, circulating tumour cells are able to differentiate histology in metastatic disease [133]. "Electronic nose" techniques showed a specificity of 71%-100% and a sensitivity of 74%-86%, although mostly in advanced disease [135]. Furthermore, they still suffer from variability.…”

Section: Molecular Biomarkersmentioning

confidence: 99%

ESR/ERS statement paper on lung cancer screening

et al. 2020

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In Europe, lung cancer ranks third among the most common cancers, remaining the biggest killer. Since the publication of the first European Society of Radiology and European Respiratory Society joint white paper on lung cancer screening (LCS) in 2015, many new findings have been published and discussions have increased considerably. Thus, this updated expert opinion represents a narrative, non-systematic review of the evidence from LCS trials and description of the current practice of LCS as well as aspects that have not received adequate attention until now. Reaching out to the potential participants (persons at high risk), optimal communication and shared decision-making will be key starting points. Furthermore, standards for infrastructure, pathways and quality assurance are pivotal, including promoting tobacco cessation, benefits and harms, overdiagnosis, quality, minimum radiation exposure, definition of management of positive screen results and incidental findings linked to respective actions as well as cost-effectiveness. This requires a multidisciplinary team with experts from pulmonology and radiology as well as thoracic oncologists, thoracic surgeons, pathologists, family doctors, patient representatives and others. The ESR and ERS agree that Europe's health systems need to adapt to allow citizens to benefit from organised pathways, rather than unsupervised initiatives, to allow early diagnosis of lung cancer and reduce the mortality rate. Now is the time to set up and conduct demonstration programmes focusing, among other points, on methodology, standardisation, tobacco cessation, education on healthy lifestyle, cost-effectiveness and a central registry.

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Training and Validating a Portable Electronic Nose for Lung Cancer Screening

Cited by 107 publications

References 27 publications

Improving lung cancer diagnosis by combining exhaled-breath data and clinical parameters

Improving lung cancer diagnosis by combining exhaled-breath data and clinical parameters

The potential of breath analysis to improve outcome for patients with lung cancer

ESR/ERS statement paper on lung cancer screening

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